Data & Trends

Diabetes Surveillance System

1999 Surveillance Report

Chapter 1: The Public Health Burden of Diabetes Mellitus in the United States

Preventive Care Practices

Persons with diabetes are at increased risk for serious health complications such as blindness, kidney failure, nontraumatic lower extremity amputations, and cardiovascular disease. Preventive care practices, such as routine dilated-eye and foot examinations, self-monitoring of blood glucose, glycemic control, and influenza and pneumococcal vaccinations, have been shown to be effective in reducing both the incidence and progression of diabetes-related complications (28-33). It is currently recommended for persons with diabetes to 1) receive annually a dilated-eye exam, a foot exam, a glycosylated hemoglobin measurement, and an influenza vaccine, 2) receive a pneumococcal vaccine, and 3) perform daily self-monitoring of blood glucose. Despite the effectiveness and benefits that can be gained from these preventive care practices, this report shows that the prevalence of these preventive care practices is suboptimal, and there is poor compliance with national health recommendations (34).

In 1997, 61.6 % of persons with diabetes in 41 states reported receiving a dilated-eye examination within the last year; 54.6% reported receiving a foot examination within the last year; 51.5% reported receiving an influenza vaccine within the last year; 39.6% reported self-monitoring their blood glucose at least once per day; 31.8% reported ever receiving a pneumococcal vaccine; and 18.4% reported having their glycosylated hemoglobin checked within the last year (Figure 10.1, Tables 10.1, 10.2, 10.3). Receipt of the preventive care practices varied by socio-demographic characteristics. Non-Hispanic whites were more likely to receive the influenza and pneumococcal vaccinations than non-Hispanic blacks and Hispanics (Table 10.3). Men were more likely than women to have their feet examined (Table 10.1). Persons who were aged greater than or equal to 65 years were more likely to receive a dilated-eye exam, foot exam, and influenza and pneumococcal vaccines (Tables 10.1 and 10.3). Persons aged <65 years were more likely to have had a glycosylated hemoglobin measurement and to self-monitor their blood glucose (Table 10.2). Individuals with at least a high school education were more likely to report receipt of most of the preventive care practices (Tables 10.1, 10.2, 10.3).

In 1997, the prevalence of preventive care practices varied by state, and in general the rates were lowest in the Southeast and higher in the North (Figures 10.2c, 10.3c, 10.4c, 10.5c, 10.6c, 10.7c). Between 1995 and 1997, there were favorable upward trends in several states in the proportion of persons who received a dilated-eye exam and the proportion of persons who received influenza and pneumococcal vaccinations (Figures 10.2a, 10.2b, 10.2c, 10.3a, 10.3b, 10.3c, 10.4a, 10.4b, 10.4c, 10.5a, 10.5b, 10.5c, 10.6a, 10.6b, 10.6c, 10.7a, 10.7b, 10.7c). In addition, self-monitoring of blood glucose has improved in the West and Midwest between the years 1995-1997 (Figures 10.5a, 10.5b, 10.5c).

Acknowledgment: The present work was supported by the Council of State and Territorial Epidemiologists (CSTE).

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This page last reviewed January 18, 2005.

United States Department of Health and Human Services
Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion
Division of Diabetes Translation